While there are many things that impact health, the two biggest factors are income and education, according to Deb Deatrick, MPH, MaineHealth senior vice president for community health services.

Deatrick recently spoke to the Belfast Rotary Club about the health status of members of the Waldo County community and the efforts under way to improve it.

In 2014 county health rankings, Waldo County was ranked as the 12th healthiest among Maine's 16 counties. Hancock County was ranked number one.

The county health rankings are produced annually by the Robert Wood Johnson Foundation and the University of Wisconsin. These rankings help counties understand what influences the health of residents and how long they will live by looking at a variety of measures. These include high school graduation rates, access to healthy foods, rates of smoking, obesity and teen births. Based on the data compiled, the rankings measure the overall health of nearly every county in the United States.

The major difference between Waldo County and the best county in Maine in each category were:

– Low birth weight: Waldo County, 7.8% vs. 5.7%

– Smoking: 19% vs. 14%

– Obesity: 29% vs. 22%

– Population to dentist ratio: 3,500 to 1 vs. 1,300 to 1

– Population to mental health provider: 680 to 1 vs. 225 to 1

Waldo County General Hospital, a member of MaineHealth, has designated tobacco use and obesity as two clinical focus areas, Deatrick said. As part of that effort, the hospital offers tobacco cessation classes and has banned all smoking on campus and all tobacco advertising in its buildings.

In response to the reported obesity data, the hospital has implemented "Let’s Go! Waldo," a 5-2-1-0 program, to help reduce childhood obesity. The hospital provides free "Journey to Health" exercise classes to the community, offers health coaching to its own employees and has partnered with more than 60 farms in the county to increase the amount of fresh, local produce being served in the cafeteria and available to the community.

Deatrick indicated these efforts are important to the long-term health of the community, but we may not see results for another five to 10 years.

Dan Bennett, the hospital's director of operations, told the audience that a previous health study showed that14 percent of our population has no health insurance and therefore no access to medical care.

To respond to that community need, the hospital introduced CarePartners, which provides free preventative care to patients who previously used the emergency department for their primary care. Since the inception of the program, $750,000 in free prescriptions have been distributed. There are 120 participants currently enrolled in the program.

In July, the hospital created Waldo County Dental Care. This vital program provides oral health services to adults who meet the eligibility criteria and have not seen a dentist in more than a year. The program's part-time hygienist has provided care to 300 patients, and the five local participating dentists have seen 200 of those patients for additional care. Waldo County will welcome a part-time, hospital-based dentist in October.

When asked what MaineHealth is doing to address community mental health issues, Bennett said licensed clinical social workers are being placed in offices of primary care providers. There is also an effort under way to increase psychiatric services through telemedicine.

Deatrick explained that health care is undergoing a huge change. Rather than being paid based on the number of patients they care for, increasingly, hospitals and providers "are being paid to help people stay healthy and keep them out of the hospital,” she said.

“Whether it's places to exercise, or farmers' markets that offer fresh produce, or volunteers who provide free transportation to seniors — these are the kinds of resources that hospitals are increasingly reaching out to, to help keep people healthy,” Deatrick said.